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Lentigo simplex in Child
Other Resources UpToDate PubMed

Lentigo simplex in Child

Contributors: William M. Lin MD, Susan Burgin MD, Craig N. Burkhart MD, Dean Morrell MD, Nancy Esterly MD
Other Resources UpToDate PubMed


Lentigo simplex is a common benign, hyperpigmented macule located anywhere on the body. These lentigines generally occur early in life (may be present at birth) and are not associated with sun exposure. They result from a mild increase in the number of normal melanocytes in the epidermis producing increased amounts of melanin.

Clinically, asymptomatic, well-circumscribed, symmetric, homogeneous, light brown to black macules are seen. They are usually smaller than 5 mm in size. They are distributed anywhere on the trunk, extremities, genitals, and mucous membranes. Lentigines found on mucous membranes can appear irregular with increased size, irregular borders, and heterogeneous pigmentation. Lentigo simplex may evolve into junctional nevi but are not thought to evolve into melanoma. They differ from solar lentigines in that they appear earlier in life on non-sun-exposed skin. They occasionally form in cutaneous scars and may be associated with psoralen / ultraviolet light therapy.

Lentigo simplex may occur as a single or as multiple lesions. Occasionally, multiple lentigines are associated with rare genetic disorders. These include the following:
  • LEOPARD syndrome – lentigines, ECG changes, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, growth retardation, and deafness
  • Carney complex – lentigines, atrial myxoma, mucocutaneous myxoma, and nevi
  • Peutz-Jeghers syndrome – lentigines (perioral and oral), multiple gastrointestinal polyps, and visceral tumors (pancreas, ovary, testes)
  • Xeroderma pigmentosum – lentigines on sun-exposed skin and multiple skin cancers
  • Cronkhite-Canada syndrome – lentigines (buccal mucosa, face, palmoplantar), alopecia, nail dystrophy, and intestinal polyps
Other rare disorders associated with multiple lentigines include generalized lentigines, arterial dissection with lentiginosis, Laugier-Hunziker syndrome, Cantú (hyperkeratosis-hyperpigmentation) syndrome, Cowden disease, centrofacial lentiginosis, and Bannayan-Riley-Ruvalcaba syndrome.


L81.4 – Other melanin hyperpigmentation

398900000 – Lentigo simplex

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

    • Individuals of African descent frequently have centrofacial lentigines that are autosomal dominantly inherited.
    • Ephelides
    • Acquired nevi
    • Congenital nevi
    • Nevus spilus appears as a circumscribed patch of light brown hyperpigmentation with smaller, darker pigmented macules or papules within the patch.
    • A café-au lait macule is macular, even-colored, and present from early childhood.
    • In children with multiple lentigines, consider
LEOPARD syndrome
      , which consists of lentigines, ECG abnormalities, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, retarded growth, and deafness. Also consider
Peutz-Jeghers syndrome
    , especially with multiple facial and perioral lentigines; gastrointestinal hamartomatous polyps are part of the syndrome.

Best Tests

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Management Pearls

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Last Updated:03/10/2020
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Lentigo simplex in Child
Lentigo simplex : Black color, Brown color, Hyperpigmented macule
Clinical image of Lentigo simplex
A close-up of two well-demarcated brown macules.
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